As part of the implementation of the Patient Protection and Affordable Care Act (PPACA), The Department of Health and Human Services (HHS) has issued an interim final rule for group health plans and health insurance issuers relating to coverage of preventive services under the PPACA.

This provision was broadened by an amendment offered by Senator Barbara Mikulski (D-MD), which requires the inclusion of a list of “preventive care” services exclusively for women. AUL was and remains deeply concerned that HHS, under the authority granted to it by this amendment, may categorize elective abortions or abortifacients as “preventive care.”

The regulation does not yet specify what additional services must be covered for women. Instead, it states that HHS is developing guidelines on “evidence-informed preventive care and screening” for women which must be covered by group health plans and health insurance issuers, to be issued no later than August 1, 2011. AUL submitted comments to HHS arguing that abortions and abortifacients should never be considered preventive care.

The Administration should listen to our advice – in fact, even pro-abortion Senator Mikulski purported to agree with us during the debate over her amendment. The text of her amendment does not explicitly require coverage for elective abortions or abortifacients. What’s more, she publicly reassured another Senator that abortion coverage is not preventive care.

On December 3, 2009, Senator Mikulski told Senator Robert Casey (D-PA) on the Senate Floor: “This amendment does not cover abortion. Abortion has never been defined as a preventive service. . . . There is neither legislative intent nor legislative language that would cover abortion under this amendment, nor would abortion coverage be mandated in any way by the Secretary of Health and Human Services.”

Further, in light of the fact that pregnancy is not a disease, it would be deeply inappropriate and even illogical to require group health plans and health insurance issuers to cover elective abortions or abortifacients under the guise of “preventive care.”

Importantly, we explained to HHS that Plan B and the newly-approved drug ella, so-called “emergency contraceptives,” should not be included in preventive care. When the FDA approved Plan B, it acknowledged that the drug not only prevented fertilization but “may also work by…preventing attachment (implantation) to the uterus. . . .”

Likewise, the FDA’s prescribing instructions for “ella” admit that ella may cause abortions. Ella has a similar chemical make-up to the abortion drug RU-486, in that it can either prevent a developing human embryo from implanting in the uterus, or it can kill an implanted embryo by starving it to death.

Requiring insurance companies to cover abortions would also violate the consciences of many Americans, and would contradict both the text of the PPACA, which includes modest conscience protections, and promises by President Obama that the PPACA does not undermine existing conscience protections in law.

We are now waiting to see the list of “preventive care” services that HHS develops. They would be well-advised to truly promote preventive medicine and not push an abortion agenda at the expense of Americans’ health.